AB0250 DESCRIPTION OF ARTERIAL STIFFNESS, INFLAMMAGING AND VASCULAR AGE IN A GROUP OF PATIENTS WITH RHEUMATOID ARTHRITIS UNDER A STRICT FOLLOW-UP COMPARED WITH UNCONTROLLED OSTEOARTHRITIS PATIENTS
Authors: A. Rojas-Villarraga, G. S. Rodríguez-Vargas, J. A. Rubio-Rubio, P. K. Bautista-Niño, D. Echeverri, L. D. Gutiérrez-Castañeda, F. Sierra-Matamoros, S. Navarrete, A. Aparicio, L. Sáenz, P. Santos-Moreno
Journal: Annals of the Rheumatic Diseases (2022)

Background The risk of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) is higher than in individuals in the general population. The fundamental risk factor for CVD is age, related to alterations at the arterial level, called vascular aging reflected by arterial stiffness and endothelial dysfunction Objectives The aim of the study was to compare vascular age and arterial stiffness (PWV-Pulse Wave Velocity) in two groups of patients with RA and with osteoarthritis (OA) and to assess the influence of inflammaging (persistent low-grade inflammation that develops with age) and metabolic markers in these outcomes. Methods Analytical cross-sectional study. RA patients under a strict follow-up program (T2T evaluated every two months) and OA patients without strict clinical follow-up, evaluated once or twice a year, were included. Patients with history of uncontrolled hypertension, CVD and/or current smoking were excluded. Waist-hip ratio, body mass index (BMI), DAS28 (RA), C-Reactive protein (CRP), Erythrocyte sedimentation rate (ESR), glycemia and lipid profile were measured. PWV and vascular age (in years) were evaluated through oscillometric method, arteriograph-TensioMed. Eleven proteins components of the inflammaging (cytokines, Matrix metalloproteinases - MMPs and its tissue inhibitors), were quantified through Luminex multiplex assay in serum samples. Univariate and bivariate analyzes (Chi-square and non-parametric correlations) were performed. Approval of Ethics Committee and informed consent were obtained. Results A total of 106 patients (74% women) were included (52/RA and 54/OA). Mean age was 57±5.6 years without differences between groups. There were significant differences in CRP and ESR (higher in RA) and in BMI, waist circumference and weight (higher in OA). RA patients had low disease activity level (DAS28: Median 2.6, IQR 1.3). There were no differences in PWV, vascular age or inflammaging (except for MMP-1, higher in RA), between the groups. PWV had a positive correlation with LDL (Rho Coef. 0.218 p=0.025). Patients who performed physical activity had a lower vascular age than those who did not [43 Interquartile range (IQR)23 vs 60 IQR 17, p=0.032). Vascular age was higher in RA patients who did not receive methotrexate 60 (IQR 19.3) compared with patients under methotrexate treatment 44.5 (IQR 23) (p = 0.017). Also, vascular age was lower in OA patients under prescribed physical activity (43 IQR 24.8 vs 56.5 IQR 20, p=0.03). MMP-9 in RA patients (Rho 0.283, p=0.042) and IL-10 in OA patients (Rho 0.290, p= 0.036) correlated with diastolic pressure. The components of inflammaging did not correlate with vascular age. The Framingham Risk Score was strongly associated with vascular age. Table 1. Significant correlations with vascular age Variable Spearman’s Rho p-value LDL levels 0.200 0.040 Systolic blood pressure 0.300 0.002 Mean arterial blood pressure 0.210 0.031 Daily coffee cups intake -0.212 0. 045 Framingham Risk Score 0.340 &lt;0.0001 MDHAQ score in RA patients 0.417 0.002 LDL: low density lipoprotein; MDHAQ: multidimensional health assessment questionnaire. Conclusion In RA strictly controlled patients, there are no differences in endothelial dysfunction, vascular age or inflammaging, when comparing with uncontrolled overweight OA patients. Physical activity, LDL levels and coffee consumption corelate with vascular age in OA and RA patients. OA patients under physiatrists follow-up and RA patients under methotrexate treatment or with low MDHAQ levels have lower vascular age levels. References [1]Inflammaging as a link between autoimmunity and cardiovascular disease: the case of rheumatoid arthritis. Santos-Moreno P, Burgos-Angulo G, Martinez-Ceballos MA, et al Inflammaging as a link between autoimmunity and cardiovascular disease: the case of rheumatoid arthritis. RMD Open. 2021 Jan;7(1):e001470 Disclosure of Interests None declared